HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Prediction of underestimated invasiveness in patients with ductal carcinoma in situ of the breast on percutaneous biopsy as rationale for recommending concurrent sentinel lymph node biopsy.

AbstractAIM:
To develop a model to predict invasion and improve the indication of concurrent sentinel lymph node biopsy (SLNB) for patients with ductal carcinoma in situ (DCIS) on minimally invasive biopsy.
METHODS:
We evaluated the data of 205 patients with DCIS in minimally invasive biopsy specimens. Clinical, radiological and histological variables were assessed in order to identify predictors of invasive carcinoma in final pathology using logistic regression analyses. We developed and retrospectively tested an algorithm to indicate concurrent SLNB.
RESULTS:
Invasiveness was underestimated in 18.0% (37 of 205). Univariate analysis revealed the following significant risk factors: lesion palpability, a mass lesion on ultrasound, the presence of a mammographically detectable mass, architectural distortion or density, a BI-RADS score of 5, a lesion diameter ≥50 mm, and ≥50% of histologically affected ducts. With a palpable mass, which remained the only independent predictor of invasion after multivariate adjustment, and the presence of at least three of the remaining five risk factors, the probability of invasion was 56.0%. If the prediction model had been used to indicate SLNB 9.8% (20 of 205) of patients could have been benefited (i.e. spared unnecessary or correctly recommended concurrent SLNB) compared to the factual performed SLNB procedures. Those patients with pure DCIS treated with breast conserving surgery (BCS) benefited most with a relative risk reduction of nearly 50% for unnecessary SLNB.
CONCLUSION:
The prediction model could rationally guide an informed discussion about risks and benefits of concurrent SLNB in patients with DCIS on minimally invasive biopsy.
AuthorsSophie Schulz, Peter Sinn, Michael Golatta, Geraldine Rauch, Hans Junkermann, Florian Schuetz, Christof Sohn, Joerg Heil
JournalBreast (Edinburgh, Scotland) (Breast) Vol. 22 Issue 4 Pg. 537-42 (Aug 2013) ISSN: 1532-3080 [Electronic] Netherlands
PMID23237921 (Publication Type: Journal Article)
CopyrightCopyright © 2012 Elsevier Ltd. All rights reserved.
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Large-Core Needle
  • Breast Neoplasms (diagnosis, pathology, surgery)
  • Carcinoma, Ductal, Breast (diagnosis, pathology, surgery)
  • Carcinoma, Intraductal, Noninfiltrating (diagnosis, pathology, surgery)
  • Cohort Studies
  • Diagnostic Errors
  • Female
  • Humans
  • Logistic Models
  • Mammography
  • Mastectomy, Segmental
  • Middle Aged
  • Neoplasm Invasiveness (diagnosis)
  • Retrospective Studies
  • Risk Factors
  • Sentinel Lymph Node Biopsy (methods)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: